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Microwave ablation after downstaging of hepatocellular carcinoma: outcome was similar to tumor within Milan criteria

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Abstract

Objectives

The aim of this study was to evaluate the clinical outcome of patients receiving microwave ablation (MWA), either after downstaging of hepatocellular carcinoma (HCC) with transarterial chemoembolization (TACE), or without downstaging when meeting initially the Milan criteria.

Methods

From January 2012 to January 2018, 66 patients with HCC beyond the Milan criteria who were downstaged by TACE previous to MWA comprised the study group. The control group comprised 190 patients who underwent MWA as first-line treatment as they met initially the Milan criteria. Cumulative overall survival (OS) and recurrence-free survival (RFS) rates were compared. The propensity score analysis was performed to reduce potential bias.

Results

Baseline characteristics were balanced between the two groups after 1:1 propensity score matching. The OS rates were 100%, 79%, and 73% at 1, 3, and 5 years in the downstaging group and 95%, 83%, and 72%, respectively, in the Milan group. The corresponding RFS rate were 77%, 40%, and 31% in the downstaging group and 76%, 45%, and 34% in the Milan group. There were no significant differences in the OS and RFS rates between the two groups (p = 0.981 and p = 0.586).

Conclusions

The long-term therapeutic outcomes of MWA for downstaged HCC with TACE were similar to HCC that initially met the Milan criteria.

Key Points

• Patients treated with MWA of HCC after downstaging with transarterial chemoembolization (TACE) were similar to those with HCC that initially met Milan criteria.

• Microwave ablation (MWA) can be an effective treatment for hepatocellular carcinoma (HCC) that is downstaged to the Milan criteria.

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Abbreviations

HCC:

Hepatocellular carcinoma

MWA:

Microwave ablation

OS:

Overall survival

RFS:

Recurrence-free survival

TACE:

Transarterial chemoembolization

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Funding

The authors state that this work has not received any funding.

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Author notes

  1. Feng Shi and Shanshan Lian contributed equally to this work.

Authors and Affiliations

  1. Department of Interventional Radiology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Second Road, Guangzhou, 510080, China

    Feng Shi, Qicong Mai, Zhiqiang Mo, Wenhang Zhuang, Wei Cui, Meng Chen & Xiaoming Chen

  2. Department of Radiology, Sun Yat-sen University Cancer Center, Guangzhou, China

    Shanshan Lian

  3. Department of Interventional Radiology, Sun Yat-sen University Cancer Center, Guangzhou, China

    Lujun Shen & Peihong Wu

Authors
  1. Feng Shi
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  2. Shanshan Lian
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  5. Wenhang Zhuang
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  8. Meng Chen
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  9. Peihong Wu
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  10. Xiaoming Chen
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Corresponding author

Correspondence to Xiaoming Chen.

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Guarantor

The scientific guarantor of this publication is Xiaoming Chen.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors (SL) has significant statistical expertise.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

The study was approved by the ethics committees of Guangdong Provincial People’s Hospital and Sun Yat-sen University Cancer Center.

Methodology

• Retrospective

• prognostic study

• Multicenter study

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Shi, F., Lian, S., Mai, Q. et al. Microwave ablation after downstaging of hepatocellular carcinoma: outcome was similar to tumor within Milan criteria. Eur Radiol 30, 2454–2462 (2020). https://doi.org/10.1007/s00330-019-06604-y

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  • DOI: https://doi.org/10.1007/s00330-019-06604-y

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